Tackling The Mental Health Minefield Part 3 - The Lovely Dr Hugh

(This post continues the story from Tackling The Mental Health Minefield Part 2 - The Admission Process)

No sooner than I had started to take in my new surroundings than another new person arrived at the door to my room. I dumped my bag with my coat and book on the bed and I accompanied the new person along the corridor. He asked whether I would like something to drink and it was the most beautiful sound that I had heard for hours. "Yes please" I quickly replied and I was offered some toast too. I quickly buttered a couple of slices of toast while my tea was being made and then armed with this sustenance, the new person and I went into another room which contained several rather upright armchairs and a couple of low tables and was somewhat strangely labelled The Quiet Room. I sat down in one of the chairs, my tea and toast were placed within easy reach, and the new person said "Hello, I'm Dr Hugh. I expect that you have probably been through all this several times today, but I need to ask you some questions and find out a little about you, then I will carry out a physical examination so that we can make sure that there is nothing physical making you feel the way you do". For the first time since saying goodbye to my GP I was actually seeing another doctor; it had only taken about 12 hours to get to this point.

While Dr Hugh had been making my tea and I had buttered the toast I told him that this was the first sustenance that I'd had since the cup of tea given to me by the lovely Triage Sister in A&E. So sitting in the 'Quiet Room', Dr Hugh insisted that I ate the toast and and drank my tea during which we just chatted intermittently. Then it was down to business.

There were all the usual questions as a full medical history was taken, the list of medication I was on was quickly dealt with because I had the two tear-off sheets from my latest repeat prescription with everything listed on it. This made making up my chart easy and it was done there and then with Dr Hugh asking what times I usually took each of them so that I could be given them at suitable times to fit in with the ward procedures. For the first time for hours I actually felt that here was someone who really cared about how I was feeling and wanted to make sure that they didn't add to my distress. After answering all the questions about my medical history it was time for the physical examination. We left the Quiet Room and stepped across the corridor to the Clinic. In here Dr Hugh again checked my blood pressure, took my temperature, and took some blood for all the usual tests. He was going to try to take the blood from my right arm but I pointed out to him that I had a really easy vein in my left arm and he would probably find it easier to use that one. On went the tourniquet, the vein immediately showed up and Dr Hugh was able to insert the needle and get his samples within seconds; he remarked how quickly one got out of practice doing things like taking blood when one decided to specialise in psychiatry.

To carry out the actual physical examination we had to return to my room as there was no examination couch on the ward. So after listening to my heart, my breathing, testing my reflexes (which don't actually react), poking and prodding all the other various bits of my body, Dr Hugh decided that there was nothing physically wrong with me. We chatted for a few more minutes and a nurse appeared with what was my normal evening medication. It was now almost 11pm and I was feeling exhausted from the emotional strain, I was sure that I would sleep no matter what thoughts might be rampaging through my brain but Dr Hugh decided that he would write me up for something to help me sleep if the night staff found that I was still awake an hour after going to bed.

There was now only one problem left to be solved. I had nothing with me other than that with which I had left the house so many hours ago; this meant no nightwear and no toiletries. But this posed no problem. the nurse who had brought my medication returned a few minutes later with a blue gown (the sort that is open at the back) and some green pyjama trousers (to take care of the problem of the gown being open at the back), a couple of towels, a toothbrush, a tube of toothpaste, and sachets of shampoo and shower gel. The nurse and Dr Hugh said goodnight to me and I was left to get myself ready for bed. I put my clothes on the chair at the foot of my bed, donned my strange night attire, and climbed into bed. My room was cold, but it took me just a matter of minutes to warm up in the bed and I was asleep a few minutes later.

I was now a patient in a mental hospital.

To be continued.

Lost Weekend

I have almost completed my first weekend at home since I left hospital and it hasn't been too bad although I haven't really achieved much.

Yesterday saw me going to collect my new toy and then trying it out. Today has mostly been spent sleeping. It wasn't intentional, it just happened. I woke early, about 6am, listened to the rain and promptly went back to sleep. I woke for a second time at about 10am, got myself something to eat, took my morning medication, listened to the rain and went back to bed (it was warm and cosy) and promptly went back to sleep again. I woke again in a somewhat confused state to find that it was dark outside and a quick check of my watch showed that it was fast approaching 5pm. Within a few minutes I could hear the rain starting again.

This means that I haven't done anything very productive this weekend, but at least I seem to have managed to be occupied in such a way that I haven't allowed the depression to take a hold on me. That has to be my goal over the next month or so and I am trying to ensure that I have as many things to do as are necessary to stop me having time to just sit and think. Unless I need to, that is. I am trying to catch up with an OU course that started while I was in hospital and that I have only been able to work on during this last week. It's just a short course, so that makes it more difficult to make up the four weeks that I wasn't working on the material.

The course is one of the OU's short creative writing courses, in this case Start Writing Fiction. I'm not sure that I have it in me to write a novel, but I am very interested in Creative Writing (it may even be why I started this blog) having spent so much of my working life employed in writing reports based on research and analysis of data. Fortunately, writing comes fairly easily to me (except when I am really badly depressed) and I have a fair grasp on the English language so finding words to express myself is fairly easy. If I'm analysing things as I write this, it probably also explains why so many of my posts are quite long.

So next week in between visits to my GP (Monday), to a psychologist (Tuesday) and to see the Home Treatment Team (probably Friday, but it's my call), I shall be spending much time in the library working on the course material and preparing my first TMA which is due next Friday, although my tutor has given me a week's extension because of starting the course late. Why the library? Well, if I'm there I find that there are less distractions to stop me getting on with the work than there would be at home. And to ensure that this all happens as it is supposed to I shall make sure that I get an early night tonight, make sure that my alarm is set so that I get up in good time to get myself dressed and ready for my appointment with my GP and that I pack my bag with computer and books so that I can head off to the library straight from the surgery.

I am so determined to try to ensure that I never again get into the state that I was in a few weeks ago, so I am going to make sure that I plan out the week ahead with all the things that I need to do making sure that there is never too much for any one day and that no days are left with nothing to achieve leaving me with too much time to think about my depression. I've done it in the past (I think that was what I was doing when I was working full-time, and studying for a degree at the same time) and I am sure that I can do it again.

And one other thing has been buoying me up over the last few days; the fabulous response that I have had to 'Tackling the Mental Health Minefield' and the huge increase in visitors to this blog. The next instalment is half drafted and will be appearing on a computer near you tomorrow.

Tackling The Mental Health Minefield Part 2 - The Admission Process

(This post continues the story from "Tackling The Mental Health Minefield Part 1 - The A&E Fiasco)

The ward that I was being admitted on to was situated on the first floor of the hospital. The nice man from the ambulance rang the buzzer at the entrance to the ward and because I was expected it took only a moment for a nurse to come and open the door. I said goodbye to the man from the ambulance, the door click closed and I found myself in a short corridor between two electronically-controlled doors being shown into a room on the left.

It was at this point that I entered virgin territory. I've been in A&E departments before, I've ridden in an ambulance before, and I've been admitted to hospital before. In fact, I actually managed all three one day in 2005 when I collapsed at work, an ambulance was called to transport me to hospital, I spent several hours in A&E writhing in agony while they managed to find painkilling medication strong enough to deal with the pain I was in, and then I was admitted for emergency surgery. However, even though I had been in several different hospitals, I had never been admitted to a mental hospital before.

I am an short (5 feet 3 inches on a good day), middle-aged (well 55 is middle-aged if you intend to live to be 110) lady, who is a bit overweight (it's the tablets that have done it, honestly), who doesn't speak any foreign languages (although I can understand what is written or said in quite a number of them), is white, London born and bred, who has travelled the world extensively but has lived her entire life in this country (always south of the Wash), and who was severely depressed, hadn't had anything to eat or drink for hours, who was emotionally drained and really just wanted to curl up in the corner and die. The nurse who was carrying out the initial admission procedure was male, more than 6 feet tall, built like a brick sh*thouse, black, from Africa and with an accent so strong that it was almost impossible for me to understand what he was saying to me.

I was submitted to an interrogation, the technique of which the KGB would have admired. I should remind you that I was being admitted voluntarily, there was never any suggestion that I needed to be 'sectioned' but you would have thought that I had stolen the Crown Jewels and then run amok slaying the Royal Family to judge by the manner of the nurse admitting me.

All the relevant personal information had been faxed through to the ward so there was no need for me to go through all that again (they also had faxed copies of all the stuff that my GP had given me when he referred me to the first hospital). So the admission process started by me being told to empty the contents of all my pockets onto the table in front of me. This didn't amount to much; just a few screwed up tissues and a safety pin (no, I don't know why I had a safety pin in my pocket either). I was then told that I could put the tissues back into my pocket, but the safety pin was confiscated. Then I had to empty out the contents of my handbag and the other bag that I had with me. I started with the other bag (it's a cloth bag that I bought in the Natural History Museum and which I invariably carry with me all the time) which contained a waterproof jacket (it had looked like rain when I had left home that morning) and a book. these were deemed to be 'safe' objects so I was allowed to put them back into the bag and keep them.

I'm afraid that I am a typical woman and my handbag contained lots of stuff. I should explain that I am a firm fan of Kipling bags, I love the fact that they are so hard wearing and that they have lots of compartments in them so that you don't end up having to rake around in the bottom of your bag looking for whatever it is that you want. I am quite methodical about where I put everything in this bag so I can always find what I want in a matter of seconds, but I was required to take everything out of every compartment and place it all on the table. Then I had to hand over the bag so that it could be inspected to make sure that I wasn't trying to hide anything. This was when I completely lost my sense of humour, which wasn't particularly good anyway. Each item was lifted from the table in turn and I had to explain what it was and why I had it in my handbag. The purse and the credit card wallet were fairly easy to explain, but I was only allowed to retain the purse (with the money that was in it). My tiny filofax with its attached pen was considered safe, so that also went back into my handbag. There followed my two Oyster cards (safe), my house keys (safe), my cigarettes (safe), my lighter (confiscated), a USB stick (safe), my digital camera which I always have in my handbag because you never know when a photo opportunity might arise (confiscated), my mobile phone which like most mobile phones also functions as a camera (safe), some of my daily medication (confiscated), two biros (safe), a lip salve (considered safe after some hesitation), my library card (safe), the tear off parts of two prescriptions which show what repeat medication that I am on (safe), a Waterstone's gift card (a birthday present from Mr Smiley) (safe), The remains of the tickets for Les Miserables and Phantom of the Opera (safe), a mini A-Z atlas of London (safe), my driving licence (confiscated), my building society account book (confiscated), and a GTN spray which I have been told that I must always have about my person (confiscated). For those not in the know, the GTN spray is for use when someone has an angina attack and as I have an unusual form of unstable angina that can occur at anytime (even when I am lying down or asleep) it is quite important that the spray is readily to hand. This completed the examination of the contents of my handbag; the safe items I was allowed to put back into the bag, the confiscated items were listed on a form which I then had to sign.

Then next form to be filled in was one listing the clothes that I had with me. Bearing in mind that all I had was what I was actually wearing, this was a little academic. But the form was duly filled in and again I had to sign it. This finished the preliminaries, so picking up my handbag and my other bag containing my jacket and a book, I accompanied the nurse from the room and went out into the short corridor and was then taken through the second electronically controlled door and into the ward proper.

At this point the nurse actually introduced himself (I have to be honest and say that I have no recollection of his name and I can't even read it on the discharge papers that I have which give details of my progress through the hospital. Then he pointed out the TV Room and the dining area before taking me to a room labelled 'clinic'. this turned out to be a room with medicine cabinets along one wall and a variety of medical equipment dotted around. My height was measured, my weight recorded, my blood pressure taken, a test for blood sugar done, and then I was handed one of those grey pressed cardboard receptacles that you get given in hospital and asked to provide a sample. As I hadn't had anything to drink for about nine hours this proved to be a bit of a problem, but with use of a running tap I eventually managed it and somewhat belligerently handed it over.

I was then taken down the corridor and shown to a room that was to be my home for the next eight days.

The whole experience was disturbing and somewhat frightening considering the fragile state that I was in. At no point was anything done to put me at my ease, or to explain what was happening. I don't think I could have been treated more unsympathetically if I had stolen the Crown Jewels and murdered the Royal Family and was going through the detention procedure at a police station with a crusty old custody sergeant.

To be continued.

New Toy

I promise that the next instalment of Tackling The Mental Health Minefield will be published later today. My excuse for not having finished writing it is that I decided to buy myself a new laptop yesterday evening, so after having ordered it (and a few other goodies) from that well-known computer store that you find on most retail parks today I have been to collect it this morning.

Having arrived home less than an hour ago I am now trying it out for the first time. I have loaded Firefox which I prefer to use as my browser, found my blog, and I'm writing this quick post on my new toy before getting myself some lunch and then sitting down to complete Part 2. Once that is published I will spend some time getting familiar with my new toy and with Windows 7.

OK, So I Lied

Sorry folks, but the next instalment of Tackling The Mental Health Minefield is taking longer to write than I thought and as I am rather tired and I am about to take my evening medication which means I shall probably be asleep within half an hour I am afraid that you will have to wait until tomorrow for it to appear. If things go according to plan, I may even post the third instalment too.

WOW!

I'll say it again. WOW!

Yesterday I had 66 visitors to my blog. Now this may not seem a lot compared to some bloggers, but for me it was a huge number. The best that I have ever managed before in a 24-hour period was 47, and I thought that was good. Strangely enough I had had almost half of those visitors before I actually published yesterday's post.

I have four separate ways of determining visitors to this blog and the figures for yesterday ranged between 34 and 66. I am using the figure of 66 visitors because that particular counter does differentiate between visitors who are first-timers and those who have visited the site before. It also looks at IP addresses as a means of identifying visitors so notes when someone visits on more than one occasion during the day and only counts them once.

Anyway, this huge amount of traffic has made me feel quite chuffed, and after the comments that came in yesterday, it seems that the posts about my time tackling the mental health minefield should be helpful/informative/amusing/horrifying for plenty of people out there in the blogosphere.

So I shall now get back to what I should be doing at the moment, which is finishing the draft of the second post in the series, rather than patting myself on the back because I had a good day for visitors. Hopefully I should finish the draft this afternoon and I want to try to get the post published this afternoon.

Tackling The Mental Health Minefield Part 1- The A&E Fiasco

Things had been going downhill for a few weeks; I was feeling lower than I think that I had ever done before, even in the first days after my husband's death. I wasn't sleeping; I wasn't eating; and I rally couldn't see any reason to carry on living. For the first time in many years I was having suicidal thoughts. Fortunately, I had enough of my brain functioning properly to know that I need help, so I made an appointment to see my GP.

His immediate response on seeing the state that I was in was one of shock. He had hoped on my previous visit that I was doing quite well after my miserable month of anniversaries and the cancer scare with the lesion on my nose. This was a Madsadgirl that he had never seen before; a Madsadgirl who looked as though she hadn't slept for a month, who walked with a shuffling gait, who has tremulous hands and who could hardly speak because she couldn't stop crying.

The obvious question followed: what could have happened for me to be in the state that I was in? The answer was simple: nothing! I had descended into the pits of hell with no helping hand, and I couldn't find my way out. Life held no future that I considered worthwhile and the result was that I felt that I just wanted to die. The thing that saved me was that I didn't have the courage to actually carry out the act.

My GP decided that I needed specialist help and a stay in hospital. He wrote the referral letter there and then, printed it off with a selection of other documents that he felt were relevant, and I was soon on my way to hospital. I reported to the A&E reception and sat in the waiting area for a few minutes before hearing my named called out to be seen by the Triage Sister, who was lovely and very sympathetic. She made a quick phone call to the on-duty psychiatric nurse and then took me through to a room specially dedicated to psychiatric emergencies in the 'majors' department of A&E. She asked me if I would like something to drink and fetched me a cup of tea. That was the last sustenance that I was to receive for more than nine hours.

After about half an hour the on-duty psychiatric nurse arrived and proceeded to take a history, which was not altogether necessary as my GP had provided most of the information necessary with the referral letter because he had felt that the fewer questions that I had to answer, the better. It should have been apparent to anyone with a modicum of knowledge to determine that I was seriously unwell and that immediate hospitalization was necessary. But the nurse's suggestion was that I went home and that the Home Treatment Team would be in touch with me in a few days. "You wouldn't like it in hospital" she said. I was somewhat perplexed because whether I would like it or not, hospital was exactly where my GP had determined I should be.

I should explain that our local Mental Health Trust has seven hospitals and which one you are admitted to is determined by where you live and/or your age and the reason that you are being admitted. There is some logic to this approach because it means that all the follow-on support can be arranged easily. The intelligence of the psychiatric nurse must therefore be called into question as she spent the next four hours trying to get me admitted to the wrong hospital!

During this period she left me in the room in the 'majors' department never bothering to see how I was or whether I needed anything. She eventually returned and told me that I could not be admitted to the 'M' hospital as I lived in the wrong part of London, something that was obvious had she bothered to read any of the paperwork that my GP had supplied, and that she should have finished work an hour earlier and that her colleague who had now come on duty was taking over my case. All of this was said in a tone of voice that implied that it was my fault that she had been trying to admit me to the wrong hospital and that I had personally was responsible for her being late in leaving for the day.

The newly arrived psychiatric nurse managed to secure me a bed in the correct hospital within half an hour, came down to see me to let me know and to tell me that he was now trying to arrange for an ambulance to transfer me. Three hours later, the ambulance arrived and I was on my way. Had I taken myself by bus I could have been in the hospital about half an hour after the bed had been secured.

I have to say that the two gentlemen who were manning the patient transport ambulance were very kind, helped me into the vehicle and out again when we arrived at our destination, and chatted to me during the whole journey. After having been left on my own so much of the day not knowing what was happening, it was extremely heartening to have such wonderful care from two people whose only task was to convey me from one hospital to another. On arrival at our destination, one of them accompanied me to the admitting ward and then wished me well as he left me at the ward entrance with the nurse who was to carry out the initial admittance procedure.

It had only taken 10 hours since leaving the GP's surgery to get me to this point.

To be continued...

Home

After six weeks I am finally back home again. Tomorrow will see the start of my posts about my experience of the mental health services provided by the NHS.

Some of what I write will show the funny side of things, some will make you wonder how anybody manages to get well, and some will show that these services leave a lot to be desired.

I have encountered discrimination, stupid rules, and nurses over-ruling decisions by consultants. Fortunately, I seem to have come out the other end relatively unscathed.

How Do I Begin To Tell The Story?

I fully intended to start writing about my encounter with the NHS mental health services but I realized that it wasn't going to be an easy or a quite task to start the ball rolling. This means that instead of sitting here in the library writing an informative post about how I ended up in hospital, I have been busy procrastinating and reading other people's blogs.

One of the problems with having been out of circulation and with very little access to a computer and the Internet is that I have become hopelessly out of date with some of the blogs that I like to read. Some prolific bloggers write several posts a day (I've even been amongst that number sometimes) but fortunately some write once or twice a week or even with less frequency. So today I have spent some time catching up with what I have missed over the last five and a half weeks and not been writing what I have promised.

The difficulty is that the whole experience has indicated to me how ill I had become without really being aware of it, and although I am definitely on the mend (can you say that about mental illness?) I still find thinking about how close I came to doing something stupid rather a scary prospect. This means that sitting here in the library writing these posts is perhaps not a particularly good idea if I don't want to cause a bit of a stir by sitting here crying onto the keyboard.

As a result of these thoughts I have decided that perhaps the best thing to do is to draft out the posts off-line, in the privacy of my room, and then publish them in the library when I come into town. The first instalment will cover the day that I went to see my GP, the decision to refer me to the hospital and the appalling way in which I was treated by the psychiatric staff in the A&E department.

Further posts will look at hospital food, nurses, recreation, stupid practices and the funny side of it all. Having to tell people that you have spent a month in hospital is bad enough, but telling them it was a mental hospital is even worse. But for all that, I have made at least one good friend (who I absolutely hated when I first met her) and have encountered one doctor who I would never hesitate to see in the future because of his compassion, consideration and humility. He wasn't bad looking either!

No Longer (A) Patient

It's official! I am free to live in the community again. My consultant was really pleased with my progress and has discharged me from the hospital. Yes, I know that I haven't been in it for a week but I was still officially a patient, and today I'm not.

I had to visit the ward today to collect two weeks of medication, but from now on I am back to getting all my various pills from my GP. While I was there I was also given my copy of my discharge summary.

Tomorrow will see the start of the posts about my experience as a 'mental' patient. I intend to cover everything that happened to me so if I repeat some of what I have already written I hope that you will excuse me. I want to see if my experience was the same as others or whether there is a definite difference in the standard of care that you can expect to receive depending where in the country that you are located.

So, all you readers out there who have mental health problems, or friends that have them, please read and comment on the posts as they appear so that I can build up a picture of what the service is like around the country.

It's Been A While

This is hopefully me starting to blog a little more frequently again. I have my laptop with me and I have logged into the free wi-fi set-up in the local library (well local to my assisted-living accommodation) so I don't have to book onto one of their computers which can be like 'rocking-horse manure' to get on to at times.

I have now been out of hospital for a week and things are improving as far as my mood is concerned, which is undoubtedly due to an increase in my medication, but I am still having problems with sleep. I either get to sleep quickly and then wake in the early hours of the morning and find myself unable to get back to sleep again, or I have problems getting to sleep so that it is almost dawn before I eventually drop off.

I have to go back to the hospital this afternoon for 'ward round' with my consultant and then I should be out on 'leave' for another week before I have to go back again. Next Monday I am due to start living at home again full time, rather than just visiting for a few hours several times a week.

I have actually been looking forward to getting back to the blogosphere and I really do appreciate all the lovely comments and emails that regular readers have been sending me. It is so heart-warming for someone who lives on their own to have so many friends out there sending messages of encouragement when you are not at your best. I really cannot express how much it has meant to me and how it has helped me during this very difficult period.

Things Didn't Go According To Plan

I'm afraid that I didn't manage a night at home last week because I was just too ill to be allowed off the ward. However, the increase in my medication has at last started to take effect and as a result I have left the ward on leave and I will be spending the next couple of weeks in assisted-living accommodation. This means that I am free to come and go as I please (no more electronically-locked doors), so I can spend some time at home, but also that I don't have to worry about cooking an evening meal and I have a room that I can retire to if I need to be alone and to sleep in.

I promise that I will pick up my laptop the next time that I visit home and will then try to write regular posts for the blog. I have so many things that I want to write about concerning my experiences over the last month that I can't wait to get back to regular blogging again.

A Big Thank You

I would like to say a very big thank you to all the kind people out there in the blogosphere who have sent me comments and emails over the last few weeks.

This has been a very difficult time for me and the mere fact that there are so many of you out there who I will never meet who have taken the time to write to me has been very heartwarming.

I'm having a few hours at home this evening and will shortly be preparing to return to the hospital. Tomorrow will see me attempting another night at home, which it is hoped will be more successful than last week. I think that I am a little better prepared and hopefully it won't be quite such a traumatic experience.

So, once again, THANK YOU, and I hope I will be back to regular blogging soon.

Still In Hospital

My consultant was a bit dismayed to hear that the ward staff had disregarded her instructions and tried to send me home for two nights instead of the few hours on the first day and then if I coped with that to allow me to spend a night at home. She knew what she had said, and I knew what she had said, but it seems that if a member of the ward staff hears incorrectly then I am not allowed to correct them; they are always right.

As a result I have spent the weekend back in the hospital again, but spending a few hours at home each day. At this afternoon's ward round I am going to ask to spend most of the day at home tomorrow, then the afternoon and evening at home on Wednesday before trying for another full night at home on Thursday.

The consultant was also very upset to find that they had sent me home from the ward without ensuring that any of the necessary support network had been set up; so that was another black mark for the ward staff.

I have a number of posts in my mind that I will be writing over the coming days and weeks, each of which will detail one aspect of the care and treatment (or lack of it) that I have received.